Three Rivers Clinic, Inc.

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

1071 Issued in MN

Legal business name

THREE RIVERS CLINIC, INC.

Practice address

6311 Wayzata Blvd
Suite 210
Minneapolis, MN 55416-1209

Phone

(952) 545-0200

Fax

(952) 545-6388

NPI assigned

May 29, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Miss Jill Robyn Behnke

Title

Ceo

Phone

(952) 545-0200

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1180396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1508067414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6311 WAYZATA BLVD",
            "address_2": "SUITE 210",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554161209",
            "telephone_number": "952-545-0200",
            "fax_number": "952-545-6388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6311 WAYZATA BLVD",
            "address_2": "SUITE 210",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554161209",
            "telephone_number": "952-545-0200",
            "fax_number": "952-545-6388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THREE RIVERS CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BEHNKE",
        "authorized_official_first_name": "JILL",
        "authorized_official_middle_name": "ROBYN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "952-545-0200",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Acupuncturist",
            "state": "MN",
            "license": "1071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.